Using Job Descriptions to Improve Medical Staff Performance

Many small and mid-sized medical practices don't have formal written job descriptions for their employees. The logic goes that new hires will just be trained on the job from the person currently working a similar position, or by the office manager, and learn the ropes as they go. This may be the case, but it often sets up employees for failure right out of the starting gate.

Creating well-written job descriptions for all of your practice's positions is a good idea for several reasons:

• Job scope and definition. First, it allows employees (new and existing) to fully understand the scope of the job and what is expected from them in terms of meeting those obligations. How often have you heard "I didn't know" as an excuse for lackluster performance? Well, before you can fault the employee, you need to ask yourself if the information was ever shared with them, and if so, in a way they could retain and understand. If the components of the job were never written down and discussed with the employee, chances are you have a weak case to make in the event of a dispute.

• Performance expectations. Think about how a formal job description sets the level of performance expectation. It is one thing for the employee to understand what is expected, it is another to understand at what level the expectation is set. For example, a well-written job description for, say, a receptionist, will not just state something like "greets patients and verifies demographic information." Rather, a good description will state "greets patients with a smile as soon as they approach the check-in desk and politely and confidentially verifies that all demographic information is up to date." So what's the difference? In the first example, if you have a grumpy receptionist and need to speak with her about her performance, she can simply state that she is meeting the requirements of the job (greeting patients and checking demographics); and she'll be right. There was nothing written that you wanted the employee to employ excellent customer service skills. Therefore, setting the level of expectation is an important feature of any job description as it allows you to manage the employee to that level.

• Performance rewards. Utilizing a well-written job description will allow you to reward employees based on performance in an objective way. Assessing performance based on the employee's ability to meet the defined criteria in the job description means that the employee has an opportunity to excel and can be reasonably assured that meeting the standards will result in reward. Conversely, not living up to the expectations in the job description will result in a poor performance review. Even better? Employees can't claim the manager is playing favorites. Either they meet and/or exceed the criteria set forth, or they don't.

• Roles and responsibilities. Defining jobs not only helps the employee performing that job, but also allows other employees to understand each other's work too. Including job descriptions in the employee manual (and having employees read and sign off on their understanding of it) allows each person on your team to have a better understanding of the roles and responsibilities of every other member on the team. Frequently, this helps set expectations between one team member and another and removes the resentment that can build when, say, the front desk staff thinks that the back office staff "ought to be responsible" for tasks that really don't fall under the scope of their work (and vice versa).

So spend the time to define your expectations in each area of your practice, commit those expectations to clearly worded and descriptive job descriptions, and use them as tools to monitor and assess performance for both your new hires and existing employees. You'll be glad you did.

Susanne Madden, MBA, is founder and CEO of The Verden Group, a consulting and business intelligence firm that specializes in practice management, physician education, and healthcare policy. She can be reached at madden@theverdengroup.com or by visiting www.theverdengroup.com.